A convertible shoulder system: is it useful in total shoulder arthroplasty revisions?

Kany, Jean; Amouyel, Thomas; Flamand, Olivier; Katz, Denis; Valenti, Philippe

doi:10.1007/s00264-014-2563-z

Cited by 35 publications

(13 citation statements)

References 25 publications

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“…6-A and 6-B) 12, 50,203,205,207 . Humeral implant design or improper stem position during the index procedure may prevent retention during revision 12, 203,207,208 . Reported complications at short-term follow-up with platform shoulder systems have included glenoid component failure, infection, brachial plexopathy, and fractures of the acromion and greater tuberosity 12,50,204 .…”

Section: Evolving Trends In Shoulder Arthroplastymentioning

confidence: 99%

Complications of Shoulder Arthroplasty

Bohsali

Bois

Wirth³

2017

The Journal of Bone and Joint Surgery

283

199

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d The most common complications after reverse shoulder arthroplasty in order of decreasing frequency included instability, periprosthetic fracture, infection, component loosening, neural injury, acromial and/or scapular spine fracture, hematoma, deltoid injury, rotator cuff tear, and venous thromboembolism (VTE).d The most common complications after anatomic total shoulder arthroplasty (TSA) in order of decreasing frequency were component loosening, glenoid wear, instability, rotator cuff tear, periprosthetic fracture, neural injury, infection, hematoma, deltoid injury, and VTE.d Glenoid component wear and loosening remain a common cause of failure after anatomic TSA, despite advances in surgical technique and implant design.d Diagnostic confirmation of infection after shoulder arthroplasty remains a challenge. In the setting of a painful and stiff shoulder after arthroplasty, the surgeon should have a heightened suspicion for infection. Inflammatory markers may be normal, radiographs may be inconclusive, and prosthetic joint aspiration may be negative for a causative organism.Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked "yes" to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work and "yes" to indicate that the author had a patent and/or copyright, planned, pending, or issued, broadly relevant to this work. 99:256-69 d http://dx.doi.org/10.2106/JBJS.16.00935 frequency) included instability, periprosthetic fracture, infection, component loosening, neural injury, acromial and/or scapular spine fracture, hematoma, deltoid injury, rotator cuff tear, and venous thromboembolism (VTE)The most common complications after anatomic TSA (in order of decreasing frequency) were component loosening, glenoid wear, instability, rotator cuff tear, periprosthetic fracture, neural injury, infection, hematoma, deltoid injury, and VTE (

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Section: Evolving Trends In Shoulder Arthroplastymentioning

confidence: 99%

Complications of Shoulder Arthroplasty

Bohsali

Bois

Wirth³

2017

The Journal of Bone and Joint Surgery

283

199

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“… 4 , 5 , 13 , 23 , 26 , 27 , 29 , 31 , 34 , 35 , 36 , 44 , 48 , 49 , 50 , 53 , 54 Nearly all prior reports have suggested that revision RTSA does decrease patient pain and improve patient-reported function. 4 , 5 , 13 , 22 , 23 , 26 , 27 , 29 , 31 , 34 , 35 , 36 , 43 , 44 , 48 , 49 , 50 , 54 However, numerous reports have also noted that final postoperative outcomes after revision RTSA are inferior to those after primary RTSA. 2 , 5 , 9 , 54 In addition, several reports have noted concerning complication rates as high as 50%-69%.…”

Section: Discussionmentioning

confidence: 99%

Effect of complications on outcomes after revision reverse total shoulder arthroplasty

Tashjian¹,

Broschinsky²,

Kawakami³

et al. 2020

JSES International

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Background Revision reverse total shoulder arthroplasty (RTSA) reliably improves shoulder pain and function in patients with failed shoulder arthroplasty, although it can lead to significant postoperative complications. The purpose of this study was to determine the effect of postoperative complications on shoulder pain and function after revision RTSA. Methods We evaluated 36 patients at an average of 4.3 years (range, 2-8.6 years) after revision of a shoulder arthroplasty to RTSA. Of these patients, 9 had a failed anatomic total shoulder arthroplasty, 23 had a failed hemiarthroplasty, and 4 had a failed RTSA. The American Shoulder and Elbow Surgeons (ASES) score and visual analog scale (VAS) pain score were evaluated postoperatively, and patients with and without postoperative complications were compared. Results The final ASES score and VAS pain score were 61 ± 23 and 2.4 ± 2.3, respectively. A major postoperative complication occurred in 7 patients (19%) (infection in 3, hematoma in 1, instability in 1, and acromial and/or scapular spine fracture in 2). Further surgical treatment was required in 5 patients (14%) (irrigation and débridement and component exchange for infection in 3, irrigation and débridement for hematoma in 1, and open reduction–internal fixation of scapular spine fracture in 1). On comparison of clinical outcomes between patients with and patients without complications, the ASES score and VAS pain score were significantly worse in patients with complications vs. those without them (ASES score, 43 ± 24 vs. 66 ± 21 [ P = .04]; VAS pain score, 4.3 ± 2 vs. 2 ± 2.2 [ P = .03]). Conclusion Revision RTSA resulted in postoperative pain and shoulder function comparable to primary RTSA reported in the literature, although postoperative complications led to clinically significant declines in function and increases in pain.

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“…11,12 This last point is particularly relevant as the revision of an anatomic prosthesis for secondary rotator cuff tear or glenoid loosening represents around 20% of the indications for reverse prosthesis. 3,[12][13][14] A short-stem press-fit humeral component with an onlay tray that is convertible from an anatomic to a RSA has recently been designed to avoid these aforementioned complications. The design aims to preserve proximal bone stock and the integrity of tuberosities and also has a decreased neck-shaft angle that provides lateralization and reduces impingement.…”

Section: Introductionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results

Ascione

Bugelli

Dömös

et al. 2017

Journal of Shoulder and Elbow Arthroplasty

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Background: The Grammont-style reverse shoulder arthroplasty (RSA) has demonstrated complications intrinsic to its design such as tuberosity fracture and scapular notching. A new short-stem press-fit humeral component with an onlay tray has been devised to avert these issues. We hypothesize that the clinical outcomes and rates of humeral complications of this new stem will be comparable to those of the traditional Grammont design and the lateralization obtained from the stem's lower neck-shaft angle will decrease the rate of notching without creating instability. Methods: We retrospectively evaluated 100 patients who underwent RSA with an onlay short-stem humeral component with a minimum follow-up of 2 years. Clinical outcomes as well as standard radiological examinations were documented preand postoperatively. Several correlations were analyzed. Results: At mean 32.6-month follow-up, the cohort demonstrated a significant improvement in several outcomes: Constant score increased from 25.5 to 69.7 points, mean anterior elevation increased from 82.1 to 141.9 , external rotation from 5.6 to 25.1 , and internal rotation from sacrum to the L3 vertebral level. There was a 30% rate of stem malalignment and 37% rate of scapular notching, not associated with any adverse clinical outcomes. The overall rate of complications was 15%, of which scapular fractures were most common (5%). Conclusion: Our short-term results suggest that the clinical outcomes and rates of humeral complications are similar to those reported for the Grammont RSA, demonstrating less scapular notching, but increased scapular stress fractures and potential subsidence of the prosthesis due to the metaphyseal press-fit require further investigations.

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A convertible shoulder system: is it useful in total shoulder arthroplasty revisions?

Abstract: A platform shoulder system allows much easier revisions.

Cited by 35 publications

References 25 publications

Complications of Shoulder Arthroplasty

Complications of Shoulder Arthroplasty

Effect of complications on outcomes after revision reverse total shoulder arthroplasty

Reverse Shoulder Arthroplasty with a New Convertible Short Stem: Preliminary 2- to 4-year Follow-up Results

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